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巨细胞病毒相关性前葡萄膜炎和青光眼的概述及最新进展。

Overview and update on cytomegalovirus-associated anterior uveitis and glaucoma.

机构信息

Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China.

出版信息

Front Public Health. 2023 Mar 1;11:1117412. doi: 10.3389/fpubh.2023.1117412. eCollection 2023.

Abstract

Cytomegalovirus anterior uveitis is the most common ocular inflammatory disease caused by cytomegalovirus infection. It mainly occurs in middle-aged males with competent immunologic function, and the incidence is higher in Asia. The clinical manifestations vary from Posner-Schlossman syndrome and corneal endotheliitis to Fuchs uveitis syndrome, and are often accompanied by intraocular hypertension. Secondary glaucoma is a potentially blinding ocular complication with a pathogenesis that includes complicated immunological factors, intraocular inflammation, different types of angle abnormalities, and the administration of steroids, which may result in physical discomfort and visual impairment. Diagnostic tests, such as the polymerase chain reaction, optical coherence tomography, ocular microscopy, and confocal microscopy, might help in identifying anterior uveitis caused by other viruses. Combinations of antiviral medications and anti-inflammatory agents are effective treatments. If pharmacological therapy cannot reduce intraocular pressure or slow the progression of glaucomatous optic neuropathy, surgical intervention is required as a last resort.

摘要

巨细胞病毒性前葡萄膜炎是由巨细胞病毒感染引起的最常见的眼部炎症性疾病。它主要发生在免疫功能正常的中年男性中,在亚洲的发病率较高。临床表现从 Posner-Schlossman 综合征和角膜内皮炎到 Fuchs 葡萄膜炎综合征不等,常伴有眼内压升高。继发性青光眼是一种潜在致盲的眼部并发症,其发病机制包括复杂的免疫因素、眼内炎症、不同类型的房角异常以及类固醇的应用,这可能导致身体不适和视力损害。聚合酶链反应、光学相干断层扫描、眼部显微镜检查和共焦显微镜检查等诊断测试可能有助于识别由其他病毒引起的前葡萄膜炎。抗病毒药物和抗炎药物的联合治疗是有效的治疗方法。如果药物治疗不能降低眼内压或减缓青光眼性视神经病变的进展,则需要手术干预作为最后的手段。

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